no body else
by michallev
Summary: My version of how Alex deals with his anger. Post ep for Brave New Word- might contain certain spoilers. Warning- mention of self abuse.
1. Chapter 1

Alex watched as the blood spiraled down the drain. It did not hurt. Just the opposite, it finally took some of his pain, his anger away.

He has been so pissed off lately; so angry, that it consumed him. He couldn't breathe, he felt as if the walls were closing in on him. He knew it was because of the whole Rebecca thing. He was just so pissed off at the way things had turned out. For just a second he had let his guards down, he let himself fall for her, let himself believe that he too can get his happy ending; that he deserved his happy ending. So he allowed himself to picture his future with her, and their baby, who never really existed. Pictured the white picket fence home with the swing set in the back yard, and the soft sound of his child's laughter. He pictured the kind of dad he would be. How he would never be like his own father. How he would give his child everything. He pictured coming home to her every night and waking up next to her every morning. He pictured himself being happy.

And then it was all gone. In a split of a second. And he had to bathe her and change her and feed her, and tell her that everything is going to be alright, even when he knew it wouldn't. he had to watch as she slowly bled out in the back of his car after she had slashed her wrists and he had to watch as the ambulance took her away to the mental institute and had to listen to her cries as she called out for him, begging him to let her stay, swearing that she will do better. It just made him so mad, the way he had been ripped off of his dreams and desires.

He had tried everything. He knew that Izzie was right, she didn't deserve his crap; he shouldn't be taking this all on her. Wasn't her fault. So he tried different things to deal with his anger. He got drunk at Joe's. And not just the average slightly buzzed drunk, but the whole "can't stand on your own, fall on your ass and black the whole thing out the next day" sort of drunk. But after Joe had expressed his concerns and even threatened to stop serving him, or worse- to call some of his non existent friends, he decided he needs something different, or at least to get drunk someplace where he'll be left all alone.

He tried to run. He ran as fast as he could as far as he could until his body gave out, and he dropped to his knees sweating and panting. He threw up everything he had eaten that day, which wasn't all that much to begin with, until he was only dry heaving. The sweat dripping to his eyes making it hard for him to see. And he still had to go back home, so he just turned around and ran back. He met Meredith and Derek when he got back, just as they were leaving the house on some sort of a night out, judging by what they were wearing. By then he was so tired and dizzy and really nauseous from the effort of running and he was pretty sure that if he so much as opened his mouth he would throw up again, that he simply nodded in their direction. They didn't even seem to notice that anything was wrong.

He tried screaming at the top of his lungs, when nobody was home. But that only left his throat raw and throbbing every time he tried to speak.

He even went to see Rebecca. He had driven for 3 hours and took her outside to sit in the sun for awhile. He sat across from her on a plastic chair and stared at the yellowing grass. He couldn't bring himself to look her in the eye. He watched her from the corner of his eyes as she silently sobbed. Wiping the tears with the back of her sleeve every few seconds. He tried to be angry with her- after all she was the reason for all of it. But watching her like that, so lost and hurting- he just couldn't find the strength to be mad at her. It wasn't her fault she got sick. If anything it was his own fault to begin with. He was the one who pulled her out of the freezing water; he was the one, who rebuilt her face; who invented this all new personality for her. For just a split second he regretted ever pulling her out of the water to begin with. But then he remembered her baby; the way it felt to hold that tiny creature, he helped bring into the world, in his arms and he felt guilty for thinking how much better his life could have been, had he not saved her mother.

Alex just continued to sit in silence in front of Rebecca, trying to fight the urge to wipe her tears with his hand, to touch her, realizing that even with all that had happened he still loves her.

After 15 minutes she asked him to leave. As he slowly got up and finally looked her in the eye, she asked him not to come back. Saying something about it being too painful, for the both of them. He wasn't really listening.

And nothing helped. He was still so pissed off, and he still felt like there was this heavy load on his chest cutting all the air, making it hard to breathe.

And then a few days ago he accidently cut his forearm on the edge of a gurney as he rushed to the Pit. The cut wasn't a too deep to require stitches, but it was deep enough to bleed for a few minutes, even after he had applied pressure on the wound. Alex was simply fascinated by it. He felt the pain, but strangely it didn't really hurt. He went into the men's room and washed the wound exposing a tiny straight cut and watched as it bled again and again. It made him feel like coming out of a long sleep. He finally felt something different; he couldn't even define what it was. All he knew was it was something other than anger, something other than his current state of numbness.

And he knew that it had felt so good.

--

A/N: What do you think? Should I continue with this story line? How do you recommend I should continue with this (if at all)? Please review this- I need your reviews to go on in this time of a writer's block…


	2. Chapter 2

Alex had been staring at the ceiling for over two hours, trying to sleep. He just couldn't seem to fall asleep these days, no matter how tired he felt, or how exhausted he was. He just lay in bed wide awake for hours and hours at a time. He couldn't get her picture out of his head, lying on the floor, a pool of blood forming around her in an alarming pace, the big knife lying on the kitchen counter dripping blood. It seemed so unreal sometimes, like it wasn't really a memory, but more like some sort of trick his imagination was playing on him.

That was the worst thought he had of the whole ordeal- that it never really happened; that it wasn't real; that he would wake up of this nightmare any time soon and find his pregnant girlfriend lying peacefully asleep next to him.

And that thought of Rebecca's attempted suicide usually brought on another thought of his mother's successful try, and no matter how hard he tried, once he let that memory slip into his consciousness he couldn't get it out of head. So he knew for sure he wasn't going to get any sleep tonight.

He still tried though. It was almost 4 in the morning (or was it late at night if you didn't even fall asleep? He found himself strangely wondering), and he's got a major surgery with Shepherd in 4 hours. And to be honest with himself he can't really afford to screw this one up. He was pretty sure that people started to notice that there was something wrong with him, even if no one mentioned anything to him. He could have sworn that they were talking about him behind his back- sometimes the crowed going completely silent as he entered the room.

He just has to get on top of his game again and then everything will fall back in place. And he will be able to go back to being the cocky surgeon he usually is, and he will be able to move on and forget all about crazy Rebecca and the child he could have had. If only he could master the surgery tomorrow everything will be alright.

He doesn't try to sleep anymore, not much use of that- it was a lost cause anyway- so he simply recites the medical procedure in his head, over and over again, visualizing every instrument, every blood vessel, every movement Shepherd will perform.

It was 4:37 when he decided to give up sleep altogether. He slowly got up to his feet and opened his bedroom window wide open, allowing the chilly air to fill the room. Even though he was only wearing his boxer shorts and was bare footed he didn't feel the cold and that sort of pissed him off. He used to love doing it when he was back home. He would wrap an old blanket around him and open his window in the middle of January letting the freezing air wash over him. It had always made him feel safe, like there was always a way to run out if he had to. It allowed him to think clearly. He loved that feeling of warmth and cold simultaneously. It made him feel safe and alive in a strange way. It made him just feel.

But these days he wasn't even feeling much of anything. He wasn't feeling cold or hot, he didn't taste any flavors when he was eating. All he felt was this huge weight on his chest, cutting all his air, choking him, making it hard to breathe. It was as if he had stopped and the rest of the world had moved on. He felt numb.

He found himself walking into his bathroom leaving the lights turned off, so he would be surrounded by the comforting darkness and opened up the window. He then picked up the 10 blade he brought from the hospital. He slowly traced his right index finger along the blade, pressing just hard enough to feel its sharpness without cutting the skin. He felt comfortable holding the blade, its shape fitted perfectly in his left hand.

He traced the blade slowly on his bare skin causing his skin to crawl in anticipation. He contemplated on where he should make the first cut. Strangely, knowing that he doesn't need the lights, doesn't need to see to make a perfect cut in the exact place in his body were he wanted to, made him feel confident in his skills as a doctor. He would always picture the human body as taught in anatomy classes during his first year in med school, carefully choosing just the right place to cut.

He never cut his arms, because that was too visible and also he wouldn't be able to properly scrub before surgery. He never cut his shin, because that didn't hurt as much. He cut himself in his abdomen or below his ribcage. Usually he was drawn to cut in his left side along an old scar he has from when his old man once stood by his word and pulled a knife on him. He also cut his inner thighs, enjoying that sense of control knowing just where to make the cut and how deep to not cause any damage in that specific area where there are a lot of blood vessels.

Alex set the knife closely to his right inner thigh and pressed the knife, breaking the skin but then he caught a glimpse of himself in the mirror. He was frightened at how much like his father he looked at that split second before making the cut, his whole body tense with anticipation of the coming pain and relief. He looked like a junky before injecting his fix- he had that haunted hollow look in his eyes and he was slightly panting and sweating, as his body prepared himself for what is about to come. He felt disgusted by himself.

He pulled the knife away and took several deep breaths. What the hell was he doing? He walked over to the window and inhaled the freezing air, filling his lungs, holding his breath for a few seconds before he slowly exhaled. He tried to get that feeling of anticipation for the pain to go away. Tried to calm him self down so he wouldn't do what he came so short of doing. But he just couldn't shake that feeling. He could still feel the cold of the blade against his skin and the beginning of relief when his skin broke. He could really sense it that overwhelming feeling of serenity, of peace, once he was pulled out of his numb state. He was shaking so badly now, making him chuckle in spite of himself. He was truly a junky. Like father like son.

And like any junky he gave in to his need, to his addiction and pressed the knife hard back to his thigh. Cutting urgently, before any thought of doubt would return. The few minutes of hesitation from before caused him self to lose that sense of control over what he was doing. He was cutting deeper and deeper, over and over again.

He finally stopped after a few minutes (or maybe was it only a few seconds? He couldn't really tell) and looked at the bloody mess he made of his thigh. He was panting a sweating as if he ran a few miles, his breaths fast and shallow. He tried to calm himself down, drew in several deep breaths trying to get the room to stop spinning. He closed his eyes, his heart pounding in his ears, heart rate high, and squeezed his hands over his knees, trying to stop them from trembling.

He got to his feet feeling just slightly swaying, feeling a little light headed and for the first time that night turned the lights on. The scene before him scared him: the floor covered in blood and the blade lying in the sink made it look like a murder scene. He took another deep breath before examining the damage he had caused to his thigh. The cuts were deep, a lot deeper than the ones he usually does and blood was slowly running along his legs, trickling dosne, dripping to the floor. He grabbed a towel, soaked it in lukewarm water and started cleaning the wounds, the towel quickly getting sort of a pink shade. It will require stitches, he noticed. He's got a suture kit in his room, so he slowly began to wrap the towel around his thigh just for the time being and cleaned up the bathroom- throwing the knife and the bloodied tissues he used to clean up the floor with, to the garbage can.

Alex then closed the window, and took another good look of him self in the mirror, noticing for the first time that he was freezing cold and that his lips took on some bluish colors. He quickly took some more tissues, clean ones, and threw them on top of the bloodied ones to cover up the mess he's made. Taking one final look at the bathroom, making sure there were no signs of what had happened there only moment before he turned off the lights again and went back to his room. For the first time in a long time he actually felt that it hurt. It wasn't just the usual pain he was looking for. His thigh throbbed with every time he leaned on it, causing him to take some of his weight off of it, shifting it to his left leg, and slightly dragging his injured right one as he walked. Damn, it hurt.

--

Derek woke up, startled by the sound of the window banging against the wall as the wind must have caused it to open. He got up quietly, careful not to wake up Meredith he shut the window closed, slightly shivering from the freezing cold air in the room. He contemplated on getting some more sleep, but noticing that it was just a little over 5 in the morning he decided against it. He's got an important surgery at 8 AM and he might as well go over the procedure over coffee. He would never admit in to any one, well maybe only to Meredith, but sometimes he still felt like he has to prove himself, to show them how good he really was. It doesn't always come easily and naturally to him, sometimes he really has to put a lot of work and effort into it. This surgery was one of these few cases that made him doubt himself and his abilities. The guy has had 2 previous surgeries that didn't seem to solve his constant seizing and shaking problems. This was his third and last try. If he were to fail the guy will spend the rest of his life in constant pain, completely dependent on others.

He pulled an old worn out sweat shirt and went out to fix him some coffee, quietly shutting the door behind him as he left the room.

He was almost at the stairs when he saw Alex Karev emerging from his bathroom, wearing nothing but boxer pants and something else Derek couldn't quite recognize around his right thigh. There was something about him that didn't quite seem right. Something was definitely off. Something about the way he walked, slightly leaning against the walls for support, or the way that he was sweating even though the hallway was freezing, or the way that he was trembling all over. If Derek didn't know better, he would have sworn that he was high.

"Are you okay?" He asked quietly, the sudden voice startling Alex, causing him to slightly jump against the wall. It was pretty obvious that he didn't notice Derek standing there until he spoke to him.

Alex slowly turned around, the slight lightheadedness turning into a full dizzy spell. Wishing the dizzy spell to go away, he faced Derek, praying that he won't notice that if he would let go of the wall he wouldn't be able to support himself. "Hah?" he managed some voice to come out not so shaky. Though he knew that the man asked him some question he had absolutely no idea what it was.

"I asked if you were okay." Derek repeated slowly.

"I'm fine. Just couldn't sleep." He said and then added "big day tomorrow."

"Today." Derek corrected. Alex simply nodded and went into his room shutting the door behind him, leaving Derek in the hallway to wonder what was going on.

Derek wanted to say something more, or to grab Alex and turn him around so he would be able to call him on his lie, since something was definitely off about him, but before he could say anything Alex had already walked to his room and shut the door. Derek went quietly back to his and Meredith's room, contemplating on waking her up and asking her if there was something wrong with Alex, but watching her peacefully sleeping, arms and legs spread across the bed slightly snoring, he decided against it. He left the room, allowing her to get a few more minutes of sleep and finally went down stairs to fix that coffee.

--

Alex managed to get back to his room and nearly collapsed on his bed. He lied on his back and watched the ceiling spinning for a few seconds. He felt really dizzy and sort of nauseous. He grabbed the suture kit from his night stand and placed it on his bed. He then got up again and slowly made it to his closet and grabbed an old towel. Going back to his bed he put the towel on the bed and set so his injured leg was on it, preventing the blood from staining the mattress. He's had that mattress since college and for some weird reason he found it hard to fall asleep on any other mattress he had ever tried.

He put some latex gloves on and then peeled off the towel, now nearly soaking in blood, revealing the deep, red, angry cuts. He thought about taking something to dull the pain before beginning to stitch himself up but decided against it, actually looking forward to the pain that is to come. He began slowly to thread the needle through his skin, not really surprised when he didn't even feel a thing.

17 stitches and an hour later and he was done. He wasn't feeling nearly as dizzy as before, but he still made himself drink the half empty bottle of water he kept by his bed. He then got up, carefully testing his suturing skills as he forced himself to put some weight on his injured leg. He grabbed the bloodied towel, the gloves and gauze that were scattered all over his bed and the floor and put it all in a plastic bag before throwing it all in the garbage can in his room.

He got dressed relatively quickly, careful not to pull his new stitches, and left for the hospital, even thought it was only 10 after 6- Might as well get there early to check on Mr. Robins before his surgery. He figured he could just grab some coffee on his way. He took one last look at his room, once again making sure there were no evident signs of what he had done there, before finally leaving; feeling really good for the first time in hours, telling himself that this is going to be a good day, and actually believing himself for a change.

--

"I don't want him on this surgery." Derek repeated for the second time.

"Well, why not?" Dr. Bailey asked in the calmest voice she could master.

"Do I need a reason?" He asked arrogantly, trying to get his whole 'I'm the big neurosurgeon attending and I don't have to explain myself to you', and all the time knowing that he will never be able to get this past Mirenda Bailey.

"Well no sir…" She answered sarcastically "but the Chief has this new policy about the first year resident's specialties, and I've notice, being the Chief resident and all, that Karev hasn't worked with you that much" she added in the same arrogant tone to match that of Dr. Shepherd.

"Look, Miranda" Derek began, grabbing her by her upper arm taking them into a more deserted hall way "It's a really important surgery and there's…. it's just that… there something off about him."

"Off? Off how?" She asked. "Look, I know he's had a hard time since the whole Rebecca incident but I haven't heard any complaints about his performances… and unless you have…."

"There is something wrong about him" He cut her mid sentence. "There was this moment last night…"

"A moment…? Look I can't just pull him off, I have to say something to him, to explain…." She said, knowing that she had already lost the argument the moment Shepherd had mentioned that he was the attending, the one doing the cutting.

"Tell him because I said so." Derek said in a voice which left no room for arguing. His pager suddenly went off and he turned to leave. "I'm telling you, Baily, there is something wrong…"

--

A/N: first of all, thanks for all the reviews- they really do help, and thanks again for all your suggestions (some I even thought of myself, and some I might have to consider now). So what do you think? Did I manage to capture Alex's distress and fast deteriorating depression? As always, further reviews are always welcome as well as your ideas as to where you think this story should be heading (because frankly- I have no idea myself….)


	3. Chapter 3

"Oh, my God, what happened to you?" Lexie asked as she entered into the resident's lounge. She came down there looking for Cristina for a brief consult on a 17 year old teenage girl, waiting for a liver transplant. But as she entered the room she noticed Alex Karev standing by his locker, wearing only his scrub shirt and a pair of boxers trying to patch up, what seemed to be numerous cuts in his inner thigh.

Alex's head snapped up as soon as he heard someone talking to him. He turned around to face Lexie Grey and grabbed his pants, quickly putting them on to try and cover the wounds. "It's nothing" He mumbled in the hopes that it will keep her from further asking questions.

"Well, you're bleeding…" She said, pointing to the cut and moving forward, slightly bending over so she could get a better look at it.

"I said it was nothing. I'm fine" He said harshly and stepped back. The last thing he needed was for a surgeon to take a look at the cuts. One look and she'll be able to tell it had been done with a 10 blade, his favorite. He should have been more careful, should have made sure that door was locked. He wasn't doing it in the hospital. That was too risky. If it somehow made its way to the Chief he would get kicked off the program for sure. And he wouldn't blame the Chief for it- Because frankly, who, in his right mind, would want a surgeon who can't be trusted around knives…

And he was also careful to not cut himself in places that were visible to others, like his arms. Because that would draw too much attention, while he was scrubbing for surgery. And he also made sure that the cuts were always covered.

But today he was so preoccupied with the upcoming surgery with Shepherd that he was getting sloppy. He was really nervous; he was really looking for an opportunity like this to come along so he would be able to prove himself to others, to show them that he is capable of being a surgeon, a good one; to prove to himself that he can do this.

Lately he felt like everything that he did was wrong. He wanted to help Rebecca, to save her, when she was trapped under the ruins. And for a while he felt like he succeeded. That she had managed to rebuild her life, to move on past the accident. And when she became sick, mentally ill, he wanted to help her get better. He wanted it so badly- as if fixing Rebecca would somehow make it up for his failure to take care of his mom. But he failed that too. And now he needed something, anything to bring back his faith in himself, the one that helped him through high school and college and med school, when he had no one who believed in himself. When everyone told him he just didn't have it in him, he was the one who pushed himself forward, who told himself he can do it. But now he wasn't so sure anymore.

So he needed this surgery, this one little thing to fix everything. He will do this surgery and he will be the best surgeon he can be. And then maybe, just maybe he will be able to move on.

He was so busy with his thoughts that he completely missed the gurney that the medics pushed through the ER doors, caring a motorcycle accident victim, until it almost ran him over. The gurney was slammed harshly in to his side, and it reopened the stitches he made the night before. He suppressed his urge to yell in pain and it wasn't until he felt the blood beginning to sip through his scrub pants he decided that it needed his immediate attention, and went into the resident lounge. He was sure that the room would be deserted. He wasn't expecting anyone to walk through the door, let alone Lexie Grey.

But now she was there staring at him. And it made him feel exposed, as if she knew and was going to call him on his bluff anytime now; was going to tell the rest of the hospital that he's crazy and should be locked up with his crazy girlfriend. But instead, she just straightened up. "Ok… " She said in a tone of voice, which made it pretty clear to him that she doesn't really believe that he's fine. "It looks that you have everything under control, it stopped bleeding… how did this happen?" She asked in an even tone.

"I don't know…. I must have run into something… didn't even feel it until someone mentioned I was bleeding…." He was surprised at himself at how easy it was to lie to her. He hated lying. Made a promise to himself a long time ago that he wasn't going to lie anymore. That he's had enough lies to last for a life time. But this lie, this little lie, came out so easily, like he had been practicing it for a while. The words just came out of his mouth as he was leaving the room along with Lexie, forgetting that he meant to bandage the cuts in the first place.

---

"What do you mean I'm off the surgery?" Alex tried to sound like it didn't really mean anything to him. "He is my patient. I admitted him in the ER… I took his history… I was the one who diagnosed him! And now you're pulling me off?" he almost yelled this time, forgetting that it was Dr. Baily he was talking to and that all the other residents were still there.

Baily waited a few seconds until all the residents and interns had left the locker room, before talking to Alex in private.

"He's my patient. It's my surgery… Why am I off the case?"

"You tell me..." Bailey said, trying to see if Derek had a point, if something is truly wrong with Alex.

"What's that supposed to mean?" He didn't get it, what the hell was going on? "You took me off the case- _you_ tell me…"

"It was Dr. Shepherd's request…."

"What?!! Why?"

"I don't know. He mentioned something about last night…."

Last night? Alex thought hard trying to remember what happened last night. He remembered running into Derek in the hall in the middle of the night. But there was nothing about their short encounter that could tell him why he was pulled off the case. Unless Derek saw something…. But he didn't act like it and Alex was really careful not to leave any traces behind him.

"He said that you are not on top of your game lately…" Bailey continued. She had to see if there was something to what Derek was saying. If Dr. Derek Shepherd himself, the head of neuro-surgery himself, seemed to be worried enough to take Alex off one of his surgeries, maybe he's got a point. And if there is something wrong with one of her residents she has to know.

"I'm fine!!" Alex snapped. "I can do my job!" In spite what everybody else think….

"Alex, If there is something wrong… If there is anything…. I need to know." She said quietly, looking deep into his eyes, trying to find the answers there.

"Nothing's wrong…" He said quietly back, but averted her scrutinizing gaze, trying to keep his voice from shaking. Dr. Bailey studied him: he seemed tired, but that was expected. He also seemed dejected but that was also expected giving everything that had happened with Rebecca. Maybe Derek's wrong, maybe everything is fine, or will be fine, at least. Maybe all Alex needs is just a little more time.

"Can I go now?" He asked after a few seconds, once he was sure his mask was fully back on he again looked into Bailey's eyes.

---

As soon as Alex had left Dr. Bailey in the locker room he ran into an empty closet room and tried to get his breathing under control. He was hyperventilating now, his breaths short and shallow and he was starting to get dizzy. He was fine, he told himself over and over and over again. Sure things had been rough the last few weeks but he was dealing with it the best way he knew how. He can still do his job. He can still be trusted with the care of his patients. He can do this.

Of maybe not. He thought sadly as he nearly collapsed on the floor. He leaned heavily against the wall, and once again tried to draw in deep breaths. He drew in a shaky breath and held it in for a few seconds before slowly exhaling. He repeated this for several times until he was able to breathe normally again, or at least until he was sure he wouldn't pass out.

Now, after being pulled off the most important surgery Seatle Grace had had in a long time, by the head of neuro-surgery none the less, everybody will know there is something wrong with him. He will never get an opportunity like this again. No other head of department will want him in their OR. He started hyperventilating again.

He didn't even remember the moment he decided to grab a 10 blade off one of the shelves. Didn't event feel it in his hand until he felt the first cut to his inner thigh, reopening all the stitches. He didn't really feel that first cut actually, so he did another one, above his pelvic bone this time; and another one and another one. He cut deeper this time, letting all of his anger at himself to wash away with his blood. He cut again and again faster and faster deeper and deeper, until it hurt, really hurt for the first time.

He then stopped, panting and sweating and looked around him. His hand was bloody, so were his scrubs, and there was also blood on the floor. Too much blood, he thought. He got slowly up, feeling lightheaded and dizzy and started cleaning after his mess. He pulled new scrubs and quickly changed, trying not to look at the numerous cuts that now covered most of his lower abdomen and his thighs. He then threw the bloodied scrubs and the blade to the biohazard bin and wiped all traces of blood from the floor with tissue before throwing it also into the bin.

He leaned heavily against the wall, feeling that he might collapse without its support and grabbed a new suture kit from on of the shelves. He waited for a few minutes with his eyes shut, trying to ignore the dizzy spell and the nausea that came, probably, from the slight blood lost. Once he was certain he would be able to walk a little without showing any signs of distress he left the room, looking for an empty exam room, where he will be able to patch himself up without anyone noticing.

He took one final look at the closet room, making sure that it was clean, before eventually leaving thinking that this is the last time, he was going to stop.

---

Alex was trying to get a few minutes of sleep before the end of his shift. To be honest with himself, he was completely exhausted. He didn't get much sleep last night and the night before that and the night before that. He couldn't even tell when was the last time he gotten more that just 3-4 hour sleep. Combined with the blood loss from early this morning (though he did let his interns practice inserting IV bags of saline in to him, which actually made him feel a lot better, and was probably the only thing that got him through his shift), he felt like he was going to crash.

He was lying on his stomach on a gurney in one of the deserted halls and in that position he felt his cut every time he drew in a breath. It stung and sort of hurt and he knew that it was wrong but he couldn't help but to embrace that feeling of pain and he intentionally leaned more on his injured side.

He sighed heavily and tried to relax just enough to be able to sleep. He knew that he was in no position to drive, not if he wants to make it in one piece back home and the last thing that he needs right now is to kill some innocent people, like that intern from Mercy that they treated last year, who fell asleep while driving after hours of surgery and killed a woman. So he tried again.

"Hey, you need a ride back home?" He heard Meredith ask in a soft voice. He did not respond. Meredith placed he left palm on his shoulder blade and slightly bent over so she would be able to look him in the eye. "You look exhausted, Alex. Lets just go home."

The way she just said it "home" made Alex almost flinch. He never really realized how much of home Meredith's house had become over the past year. Not until she almost kicked him and Izzie out last week.

It wasn't the first time he had been kicked out. His father kicked him out once when he was fourteen. It was late January and after almost 4 days on the streets he had developed pneumonia. Only after a quick trip to the emergency room, the courtesy of the officer who found him hacking up a lung in the park and a threat to press charges against his parents for neglect by the ER attending, had his parents agreed to bring him back home.

His mother kicked him out a couple of years later, after his dad was long gone, when one of her boyfriends insisted on it.

So it wasn't the first time he got kicked out, but it was the first time he actually cared. That was when he realized that for the first time in his life he truly felt at home.

"Yeah, ok" He finally said as he got to his feet, making sure that the cuts weren't bleeding again, or at least that there were no traces of blood on the gurney or anything else that might draw Meredith's attention.

They walked slowly to the parking lot, Alex setting a very slow pace. He felt really sick and if Meredith wasn't there he would probably give in and throw up right there and then, but instead he stopped and drew in deep breaths.

"Are you okay?" Meredith asked in concern when she saw that Alex stopped walking.

"Yeah, just a very long day…." He answered and resumed walking.

"I can talk to Derek…." She began. Maybe if she talked to him, he will cut Alex some slack. It was no secret that he was pulled off the surgery, thought the speculations as to the reason, were a whole other story and varied from a long lasting drinking problem, to an argument over the living arrangements of Alex and Shepherd; and thought Meredith didn't contribute to the hospital's chain of gossip she was still curious like the rest of the hospital's staff. She also wanted to make it better for Alex. She lived with the guy, she knew, even if Izzie didn't tell her, that he was going through a rough patch. It wasn't hard to notice the dark circles under his eyes and the depressed slightly haunted look in his eyes. And despite what other people think of Alex Karev, Meredith knew that he is a decent guy, and he deserves a break.

"I can fight my own battles." He said quietly, just above a whisper and for his surprise he didn't sound bitter, and more surprisingly he really wasn't angry at all at Meredith for butting in. "I don't need you to use your special relations with the head of neuro-surgery to get me into surgeries. If you want you can use them to get yourself a head…." He replies with a smirk in what he hoped was a remark remotely similar to his usual self. The walked the rest of the way to the car in silence, avoiding eye contact.

When they got to the car Alex had to fight hard to suppress a groan when he attempted to sit down in the passenger sit. The slight motion puling at his new stitches. He glanced over briefly at Meredith hoping that she didn't notice. She waited a little in the car, the car keys still in her hands.

"Meredith?"

"Are you okay?" She asked seriously looking him straight in the eyes and he knew she wasn't talking about just the difficulty he had getting into the car and sitting down.

"Let's just go home…." He said dejectedly, avoiding her question.


	4. Chapter 4

Alex woke up with a killer headache. He glanced at the alarm cloak – 3:17 AM. Fucking great, he thought. He finally fell asleep around 1 AM, avoiding all of Meredith's worried looks and personal question. "No, nothings wrong. Yeah, he really wanted this surgery; No, it's not the end of the world to get kicked off the case; No, he doesn't know why Shepherd did it, do you?" He dared to ask her. "He's fine; really he's okay, so just stop asking." And with that finality he went to his room and practically slammed the door in her face. He sighed deeply and leaned against his door, feeling just a little bit guilty about snapping at Meredith, when he knew she only meant well.

He went straight to bed after that but it took him a very long time to fall asleep, Rebecca's pictures kept popping into his mind – her pale face and her bloody slit wrists.

He felt this slight itch, that familiar desire to pick up his 10 blade he kept at his drawer and make this all go away, but he actually made a promise to himself to stop, or at least to try and stop. And since he had only made that promise to himself a few hours ago he felt embarrassed to give up so soon. Even if the promise was to himself and no one else would ever find out. So he settled for slightly prodding at his new stitches instead, pressing just so he would feel some pain but not tare them open. Eventually he fell into a fitful sleep.

He woke up two hours later, at 3:17 AM. He felt really sick all of a sudden – he could feel his cheeks burning and that joint pain he always got when he ran a fever. He closed his eyes and fought back the nausea. He could hear his own heart bit and that only aggravated his headache. God he hated being sick.

He got up slowly and nearly stumbled over his shoes, put on an old sweatshirt and went down stairs to grab a glass of water. He open the refrigerator and left the door open for a few seconds, leaning in, letting the cold air to cool his fever. It made the chills worse but he always enjoyed that feeling when he was sick – that feeling of being hot and cold simultaneously. He grabbed a bottle of water and painfully stretched up. He turned around and suddenly he was so startled by another presence in the kitchen that it made him drop the glass.

Alex didn't say anything, just started picking up the pieces of glass, which scatted all over the floor. He had to restrain himself not to use any of the large sharp ones.

"Sorry… I didn't mean to startle you" Derek said quietly as he began picking up the pieces as well. Alex did not respond.

They worked in silence for a few minutes, picking up the large pieces of glass, moping up the kitchen floor. Putting everything back to its place.

"Something's wrong." Derek was the first one to break the silence. Alex just froze in his place for a few seconds and then went on to swiping the floor for any small undetected glass.

"Even if you don't see it right now, something's wrong." He spoke so quietly and evenly. He looked straight into Alex's eyes and he almost believed him, almost fell for it, almost felt that Derek Shepherd really cares about him. And for just a split second, he almost told him. The sentence already worded in his mind "I'm having a really hard time with this whole Rebecca losing her mind and trying to kill herself thing… I have been cutting…" he almost gave into that sense of relief that comes with every confession. Almost.

"And you are risking your patients when you go into the OR like this…"

Alex felt his heart sink with every word. Shepherd only cared about the patient's, about the hospital's reputation. It had nothing to do with him. He started to leave when Shepherd grabbed his arm, as he was obviously not quite finished.

Suddenly, as Derek touched him, he could feel the hit radiating off him.

"You're burning up…." He said softly, genuinely surprised.

"I'm fine." Came the usual reply.

"I'm going back to bed." He said to Derek and pulled his arm free, going straight back to his room without having that glass of water.

---

"Are you doing drugs?" Meredith asked bluntly.

"Hah?" Alex grunted at her general direction. God, she could have at least bothered to knock, he thought.

"Are you doing drugs?" She repeated the question. "Because Derek said that he ran into you last night in the hall and that you seemed high and that's the reason he pulled you off the Emerson case." She cleared as she approached him, sitting on the end of the bed.

Alex felt the weight shifts on his bed and open his eyes slightly; the room was spinning dangerously around him, making him nauseous. He could have really used that glass of water, he thought sadly. "I'm not doing drugs." He said evenly.

Meredith studied him for a few seconds contemplating on whether he was lying or not. She knew him well enough to know that he hated lies, but she didn't know if that applies to other people's lies or his own. "So why would Derek think that you were getting high in the middle of the night?"

"How should I know? He's your boyfriend, ask him." He snapped at her and turned over, so he wouldn't have to face her. It also made the cramps in his stomach to subside. He should have warned her – he's always snappy when he's sick.

"Alex…" She started, not sure if she wanted to pursue the matter. "You have to admit that you have been a little off your game lately…." She continued quietly.

He turned slowly so he could face her, trying to control both his anger and the sudden wave of nausea, which almost made him gag. "You were a little off your game when your mother was first hospitalized here…" He spoke quietly, through clenched teeth. "And then you were off your game after you had almost died… but no one ever questioned your ability to do your job…"

"No one saying you can't do your job, Alex…. They're just worr…"

"Your boyfriend thinks other wise…" He said, cutting her mid sentence.

"I can still do my job, Meredith…" He said so dejectedly, that Meredith felt really sorry for him; he really could catch a break lately.

She moved closer to him and placed her hand over his forearm. "Alex, you're burning up…" She said and placed her hand over his forehead.

"You're the second person to tell me that in the past hour…"

He closed his eyes as the room started spinning faster and faster and he was afraid he might throw up all over her. He then felt the weight on the bed shift again as she got up. He also felt a sudden cold as she pulled her hand away from his forehead.

"I'll be right back."

Alex nodded back to a fevered sleep but was awaken once more as something cold was pressed against his burning forehead. "Alex…, Alex…." Meredith shook him awake. "I need to take your temperature." He was going to say something but the minute he opened his mouth to say it a thermometer was placed under his tongue and he was too exhausted to even protest.

They waited for a few seconds; Meredith rearranged the wet cloth she had placed over his forehead until the device beeped. She took it out and stared at it, slightly frowning. "103.6… It's pretty high. He wanted to say something, like "I'm fine" or "It's not that high" but found that his tongue felt too thick and too sticky.

A sudden wave of nausea washed over him again and he felt his stomach cramping as well as bile rise at the back of his throat. He knew what would come next and he also knew that he would never make it to the bathroom in time. So instead he just rolled over on his right side, just as his body finally gave into the nausea and he started retching violently; his stomach cramping painfully over and over again.

"Oh, shit…" Meredith cursed at the sight of Alex vomiting. To his credit he rolled over just in time, so he was throwing up mostly on the floor but at least he wasn't choking on his own vomit or vomiting all over his bed. She quickly grabbed the garbage bin from the corner of the room and placed it beside the bed. Sitting on the edge of the bed she supported Alex's shoulder with one hand, slightly pushing him over, so he wouldn't role back on his back, while rubbing big soothing circles on his back.

After a few minutes the cramping stopped and he sank back on his back; sweat covering his forehead and he was panting from the exertion. He drew in deep breath, or at least as deep as he possibly could and waited for the room to stop spinning.

Meredith left again and came back with a glass of water. She then helped him into a sitting position and handed him the glass, waiting for him to finish rinsing his mouth.

"How about we'll get you out of his sweaty clothes, hah?" She said, expecting his usual sexist blunt remark, not surprised when he didn't reply, but he did straighten up some more in his bed to help her get his shirt off.

Alex felt a sudden chill as Meredith pulled off his shirt, leaving him bare chest, wiping his sweat with the wet cloth from before; his teeth chattering. "I know you're cold, but you have a really high fever, we need to bring it down… " She explained as she went through his closed to find some clean clothes. Alex didn't even protest.

"You have to take your pants off too." She said and so he did. And he didn't think. Didn't think about what she might find out once he would be stripped to his boxer shorts. Didn't think about what she might think of him or what she might tell everyone. He just didn't think about nothing at all, except how good it felt to be taken care of for a change; that you don't have to worry about a thing, just do as you are told. Just to trust someone to make it all better. He just didn't think. Not until he heard Meredith's sudden draw of breath and her quiet "Oh, Alex, what have you done to yourself?" soft whisper.


	5. Chapter 5

"Alex?" Meredith tapped him gently on the shoulder.

"Hah?"

"We're here" She said quietly as she turned the ignition off and exited the car.

Alex embraced him self for the pain that were too come once he'd have to move. He felt as if his lower abdomen was on fire and the mere thought about getting up, walking to the house and then climbing the stairs up to his bed room made him nauseous. But he also didn't want to alarm Meredith that something was wrong so he took a few deep breaths, opened the door and then slowly and painfully stretched up, stifling a groan.

"You coming?" He heard Meredith yelling as she quickly ran the few steps towards the house and was already unlocking the door.

He then shuffled his way towards the house, grateful that Meredith wasn't watching. He decided to leave his coat on just in case he was bleeding again and to head straight to his room. He was just starting to climb up the stairs when Meredith emerged out of the kitchen.

"Hey, do you want to watch a movie or something?" She asked.

"No thanks" he answered flatly. "I think I'm just going to go straight to bed." He said and turned his back on her, only half hearing her mumbling something about it's being only 8 thirty or something. He really didn't care.

He stumbled to his bed room and shut the door behind him. He then exhaled slowly took his shirt off and set on his bed to examine the damage.

It wasn't as bad as he first thought. The stitches he performed on himself seemed to hold on, though the wounds themselves seemed a bit red and puffy. He gently pushed on the wounds to see if it caused any pain to check for an infection, but he found that he felt no pain at all. Not the pain indicating an infection and not the simple pain that usually came when you pressed on an open wound. He would have been alarmed but lately he found that his pain tolerance had increased, so he didn't think too much into this.

He spread some antibiotic cream on the wounds on his stomach and just to be on the safe side, he also spread it on the wounds on his inner thigh, though the wounds there weren't as red and puffy. He then redressed the wounds, tossed the old bandages in the bin and ducked under the covers. It really had been a very long day. Though, come to think about it, he really didn't do all that much, with his surgery been cancelled and all. But he still felt completely exhausted. So he just closed his eyes and tried to get some rest without thinking about how he fucked up his only chance at proving everyone that he was still a competent doctor. And the worst part of it was that he truly didn't have any idea why he was thrown off the case. But he tried not to think about it, or about the burning sensation in his stomach, or about the increasing nausea. He just tried to relax and breathe. He just tried to breath.

---

"He needed it!" Meredith tried not to raise her voice. "He needed this surgery, and you kicked him off the case!" the last sentence was shouted quietly.

"I know… I know his your friend… I…" Derek grabbed Meredith's arm as she tried to walk out of the kitchen and turned her around so she would have to face him. "I know his your friend…" He said more gently. "But there was something off about him and I … I didn't want him in my OR. I couldn't trust him in my OR." He sounded like he was apologizing at this point.

"You don't understand… after everything that's happened… after the whole Rebecca fiasco… I really think that he needed it. That it was more than just an interesting procedure. He needed it."

"I know. You said it already. But he wasn't right. I saw him last night and he looked high…" Derek finally admitted.

"He wouldn't…" Meredith found it hard to believe that Alex of all people would do drugs.

"Maybe it wasn't drugs. But he was definitely not alright. And I couldn't risk my patient like this. It was a dangerous procedure as it is. I just couldn't risk it." _you understand_ He said quietly to himself. "Meredith. I really think there is something wrong with Alex…"

"You're wrong" Meredith tried to explain. But at that point she was also starting to get worried. She wasn't blind. She knew that he had changed over the last few weeks, but she honestly thought that all he needed was to get back on his feet. To be a surgeon again. To heal people. If he's just be able to help others, he might be able to help himself.

---

Alex woke up sometime after midnight and the first thought that came to his mind was a complete surprise that he had managed to get any sleep at all. The second thought was the searing hot white pain that ripped his stomach every time he moved or breathed. The third thought was that it was too damn hot in his room. The fourth thought was that he was definitely going to throw up.

He stumbled out of bed and nearly threw up on the floor when the pain momentarily blinded him when he'd tried to stretch up. So he just stumbled to his bathroom doubled over, quietly thanking whatever God there was that nobody seemed to get up.

He made it to the bathroom just in time and fell to his knees in front of the toilet retching violently. His stomach clenching and unclenching and clenching again painfully, making it hard for him to breathe.

He felt the stitches he preformed only hours before tear open. He broke into cold sweat but he just couldn't get him self under control. So he just stopped trying. He caved to the pain and let it take him over numbing all his senses until all he could feel was the excruciating pain.

He knew now for sure that the wounds were infected. He could feel the heat radiating off of them. He also felt a mild joint pain, the one that came along when ever his fever spiked over 103.

After a few moments the vomiting finally stopped. He wipes the sweat off his brow with the back of his hand and laid his head on his hands getting his breathing under control. Taking a deep breath and holding it in for a few seconds before exhaling. He repeated this for a few more times until he was sure he wasn't going to pass out and then stretched up. Forcing himself to stretch all the way despite his wounds. He then flushed the toilet splashed some cold water on his face, rinsed his mouth and finally opened the light to survey the damage to his stomach. He squinted at the bright light for a few seconds before his eyes adjusted and then looked in the mirror.

The sight of his own reflection shocked him. The stitches on his wounds were torn open. He knew that already, he could feel the blood trickling down his body for the past few minutes. What he didn't expect to see was his pathetic self staring back at him. He looked awful: red rimed eyes, shallow expression. He looked sick or high or maybe both. Maybe he is sick. Maybe there is something terribly wrong with him. Maybe he's so broken and cannot be fixed. Maybe he was just spreading poison around him, hurting everyone who dared get close to him.

And suddenly he felt so angry at him self. So self loathing. No wonder he was kicked off the case. He wouldn't trust him with a scalpel if he were Derek Shepherd. He looked like he was about to fall over. He hated himself so much at that point. He was finally given the chance that he wanted, but he screwed it up. He could blame Dr. Shepherd all he wanted, but the truth was that he had no one to blame but himself. He brought this upon himself. There was no one else to blame. No body else.

And then another realization set in. Not only is he not capable of helping people, he was actually destroying them. He was the one that fucked up Rebecca. Sure, he pulled her out of the water and saved her baby. But the truth was that he could not save her. Not really. He fixed her new face and had given her hope of a better future, just to have it all taken away. It was his fault that she went nuts. He picked her face, picked her personality to suit himself. It was all his fault. No wonder Rebecca didn't want to fight hard enough for him to stay alive… he's pathetic. A poor excuse for a doctor.

The rage was so sudden and consuming that he wasn't even thinking. His razor blade was in his hand in a matter of seconds, the feeling of it in his hand so familiar and comforting. Alex made the first cut without even thinking and then cut deeper and deeper into the already open wounds in his stomach. He cut over and over and over again. Ignoring the pain. Ignoring the feeling of the blood, now flowing freely down his legs. He was just so angry as he cut and hurt himself worse than ever before. He was screaming too, he realized. Screaming with the rhythm of every cut. He didn't even care if anyone could hear him. He just couldn't help himself. When they would ask him about it later he wouldn't even remember doing so. He wasn't even sure he was fully conscious then.

He cut even deeper, his fingers digging into his own flesh. But he still felt nothing but the pure anger and resentment towards himself. It didn't hurt. He felt no pain. But with a slight alarm he did notice that the edges of his vision began to blur.

And just a suddenly as the anger came it just left him. He was panting now, breaths coming in short and fast. Too fast. He dropped the blade at once and looked in the mirror again. The sight of himself bleeding surprised him some how.

What has he done?

He was covered in blood, his blood, and as the looked up the room tilted dangerously on its axis making him feel light headed. He kept staring at his reflection mesmerized for a few more seconds, almost hypnotized at the sight of his own blood. Suddenly he had to vomit again. Unable to move he just threw up in the sink, the nausea washing over him in waves. Every time he thought he was finally done he looked up and the sight of his own bloodied reflection set another wave of dry heaves. He had tried to drink some lukewarm tap water, but it all came back up only seconds later. He dry heaved into the sink for a few minutes before he forced himself to stop and regain control.

Alex knew that something was terribly wrong. That it wasn't his usual cutting. He couldn't get the bleeding to stop or to even slow down. He grabbed a towel and pressed it hard against his stomach. Scared when he didn't feel any pain. The towel was soaked in his blood within seconds. He washed it in the sink and applied pressure against the wounds again.

"Come on, come on, come on, come on" He talked to himself trying to convince the bleeding to stop on its own. But it didn't. He was bleeding quite heavily and he started to panic. At some point he had dropped the towel and as he tried to grab it off the floor he nearly passed out. The bathroom spinning around him making it hard for him tell which way was up and which way was down.

He put one hand on the sink as he finally grabbed the towel with his other hand and got up. He put the towel against his stomach again and suddenly noticed that the blood was coming out in short waves the rhythm of his pulse.

And then he knew he had to get help.

He stumbled out of his bathroom, not even caring about the exposed bloodied mess he had left behind. He tried to make it to Izzie's room which was the closest. He had tried to remember if she was home but he honestly did not know. He knew for sure that Meredith was home so he stumble towards her and Derek's room when his legs gave under him and his knees buckled. He leaned heavily against the wall. Feeling dizzy and light headed and really nauseous. He slid slowly to a sitting position slamming his eyes shut against the nausea that hit him. He could feel bile at the back of his throat and it took all of his will power not to throw up again all over the floor. He could feel the hall spinning around him. He tried calling out for Meredith or Derek but no words came out.

---

Derek woke up frightened at the sound of someone screaming. He straightened up in bed looking at a disoriented Meredith lying next to him.

"Did you hear that?" He asked Meredith but got no response. "What the hell was that?" He asked her but she didn't seem to hear. He pulled an old sweat shirt over himself and quietly left the room to check it out.

He wasn't expecting to see Alex in the hall. He was briefly reminded of the night before when he suddenly realized that something was very wrong. Alex looked scared, terrified even. "Alex, did you hear that?" He asked him, but Alex didn't seem to notice his presence.

He was about to ask him what was going on when the rest of the picture registered in his mind.

Alex was holding a towel to his stomach and was leaving a bloody trace behind. He also notices the bandage on his left thigh. Oh god, he thought to himself, Alex had been stabbed. He had been stabbed in his house, by some intruder, who could still be in the house, while Meredith was still asleep in the next room.

"Alex, what happened? Is he still in the house?" He whispered, but still got no response. He made a quick motion to grab Alex, who seemed unsteady on his feet when all of a sudden he just collapsed against the wall.

He kneeled by him tapping Alex's face gently. He could feel the heat radiating off of him and the slight tremors that rocked his body.

"Alex. Alex. I need you to focus." He said a bit louder and to his surprised Alex opened his eyes and looked at him, though his eyes were glassy fevered bright and didn't really focus on him.

"Is the guy that did that to you still in the house?" He asked again, trying not to sound as scared as he felt.

"No.. There was no one else. Nobody else…there's nob'dy else" Alex answered, slurring his words. And then it all made perfect sense to Derek.

"Oh my god… Meredith. Meredith! Meredith!!" He yelled as he tried to pull the towel away and asses the damage.

"What?" Came Meredith's sleepy response as she came out of their room. It took her a couple of seconds to realize what she was seeing.

"Oh my god. What happened?"

"Call 911" Derek instructed quickly before Meredith had even reached them. "Alex. Alex can you hear me?" He asked as he noticed that Alex closed his eyes again. On purpose or because he had lost consciousness, he did not know. Derek rubbed his knuckles against Alex's sternum. Alex didn't even flinch in pain, but he opened his eyes once again. But this time he seemed completely out of it, as if he wasn't even seeing Derek, who was right in front of him. In the distance Derek could hear Meredith giving the paramedics directions to get to the house.

"Alex, I need to have a look." Derek said as he tried to pull Alex's hands away from the towel, but Alex would not let him.

"Alex, you're bleeding, I need to see how bad it is." He tried again, but still got no response.

"Alex, it's okay." Meredith said as she kneeled by his other side. "We're only trying to help you. Let me look" She said again as she placed her hands on Alex's and removed the towel. "Jesus. What happened?? How did this happen?" She asked as she exchanged a look with Derek. It was perfectly clear that the wounds were self inflicted.

"Where are the paramedics?" Derek asked to no one in particular.

"Can't you just fix it here?" Alex finally spoke in a quiet whisper. Looking directly at Derek and he seemed lucid for the first time that night.

"Alex these wounds are very deep and some of them are infected. You need a hospital" Derek answered.

"Please, Meredith…" Alex spoke to her ignoring Derek's last comment. "They'll kick me off the program…." He added. His own admission confirming Meredith's and Derek's initial suspicion.

Meredith didn't know how to respond to that. It was probably true. But it wasn't important at the moment. All that mattered was to get Alex some help.

"Alex." Derek spoke again. "I'm going to press it against your stomach again to slow the bleeding. It might hurt." He said as he applied the pressure. Alex didn't even flinch. The lack of response to the pain from Alex worried him. The young intern was probably already in shock.

"He's burning up" Meredith stated the obvious as she laid a hand on Alex's back. "Alex stay with us." She said again as his eyes drifted shut again. "Alex. You need to stay awake." She tried again, but Alex was no longer conscious. She then turned towards Derek.

"How could we have missed this?"


End file.
